Healthcare Provider Details

I. General information

NPI: 1386848026
Provider Name (Legal Business Name): RUTH ELAINE BUELL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 EAST 23RD ST.
HUTCHINSON KS
67502
US

IV. Provider business mailing address

228 EAST LIBERTY ST. P.O. BOX 578
MAIZE KS
67101-0578
US

V. Phone/Fax

Practice location:
  • Phone: 620-669-5241
  • Fax:
Mailing address:
  • Phone: 316-518-9279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-00361
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: